The Effect of the Earned Income Tax Credit on Physical and Mental Health—Results from the Atlanta Paycheck Plus Experiment

Original Scholarship
Mental health

Policy Points:

  • The Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta.
  • In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health.
  • In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health.

For workers who eke out a hand-to-mouth existence, an income supplement at tax time could plausibly have a positive and measurable impact on economic well-being and health by improving purchasing power for healthy foods or renting an apartment in a safer neighborhood.1 It could also alleviate the psychological stress associated with living paycheck to paycheck, which is associated with premature aging throughout the life course.23 However, it is difficult to qualify for many welfare programs in the United States, and often the neediest go without because of bureaucratic barriers, such as onerous filing requirements.4

Low-wage work can be a particularly insidious health threat for single adults without children in America because this group is often ineligible for welfare income supplements. Although single adults without custodial children are eligible for the Earned Income Tax Credit (EITC), they are only eligible for one-fourth of the amount provided to single parents with one child.5


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  5. Falk G. The Earned Income Tax Credit (EITC): an overview. Congressional Re-search Service. Published October 22, 2014. Accessed September 22, 2023.

Muennig P, Belsky DW, Malinsky, D, Nguyen K, Rosen Z, Allen H.The Effect of the Earned Income Tax Credit on Physical and Mental health—Results from the Atlanta Paycheck Plus Experiment. Milbank Q. 2024;102(1):1005.